Presystolic murmur

A presystolic murmur, also called presystolic accentuation, is a type of diastolic heart murmur typically associated with the opening snap in mitral valve stenosis. It is heard following the middiastolic rumble of the stenotic valve,^[1] during the diastasis phase, making it a "late diastolic" murmur.

The murmur is heard due to antegrade flow of blood through a progressively narrowing mitral opening during the end of the atrial systole. This antegrade flow through the mitral valve before it completely closes appears to be the result of a pressure gradient at the end of diastole.^[1] As its name so indicates, the presystolic murmur is heard before the mitral valve produces the S1 heart sound.

Less often, a presystolic murmur can be heard when a right atrial myxoma causes a tricuspid valve obstruction to blood flow.^[1]

References

1 2 3 Eric J. Topol. The Topol Solution: Textbook of Cardiovascular Medicine, Third Edition with DVD, Plus Integrated Content Website, Volume 355. Lippincott Williams & Wilkins, Oct 19, 2006; page 222. ISBN 0781770122

Eponymous medical signs for circulatory system

Heart disease

Heart murmur	Systolic heart murmur: Benign paediatric heart murmur (Still's murmur) Diastolic heart murmur: Pulmonic regurgitation (Graham Steell murmur) Aortic insufficiency (Austin Flint murmur) Carey Coombs murmur Mitral regurgitation (Presystolic murmur)

Aortic insufficiency	Watson's water hammer pulse/Corrigan pulse De Musset's sign Duroziez's sign Müller's sign Quincke's sign Austin Flint murmur Mayne's sign

Other endocardium	endocarditis: Roth's spot Janeway lesion/Osler's node Bracht-Wachter bodies

Pericardium	Cardiac tamponade/Pericardial effusion: Beck's triad Ewart's sign

Other	rheumatic fever: Anitschkow cell Aschoff body EKG (Osborn wave) angina pectoris (Levine's sign) Gallavardin phenomenon

Vascular disease

Arterial	aortic aneurysm (Cardarelli's sign, Oliver's sign) pulmonary embolism (McConnell's sign) radial artery sufficiency (Allen's test) pseudohypertension (Osler's sign) thrombus (Lines of Zahn) Adson's sign arteriovenous fistula (Nicoladoni sign)

Venous	Friedreich's sign Caput medusae Kussmaul's sign DVT Bancroft's sign Homans sign Lisker's sign Louvel's sign Lowenberg's sign Peabody's sign Pratt's sign Rose's sign Trendelenburg test superior vena cava syndrome (Pemberton's sign)

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